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I've heard the following two sentences and I'd like to understand the differences between the two, if any, and when it is appropriate to use one vs the other:

おいしゃさんはなしています

おいしゃさんはなしています

It is my understanding that these both translate to "I am speaking to the doctor", but what is the difference between and here?

4

おいしゃさんはなしています is "I am talking with my doctor", whereas おいしゃさんはなしています is "I am talking to my doctor".

The first one with と is natural in most cases, because when you go to a doctor, normally both you and your doctor will talk to each other.

~にはなす can be naturally used when you're talking to something that do not reply to you:

彼【かれ】は人形【にんぎょう】に話【はな】している。
He is talking to a doll.

...or what is important is whom you are talking to:

私【わたし】はあなたにではなく、お医者【いしゃ】さんに話【はな】しています。
I am talking not to you, but to my doctor!

1

It is the same as the difference between talking 'with' someone as opposed to talking 'to' them. おいしゃさんにはなしています can mean that some information is being conveyed to the doctor (basically 'telling' them). と does not imply such a nuance.

お医者{いしゃ}さんに言{い}う would be simply conveying that information, but お医者{いしゃ}さんに話{はな}す implies discussion relevant to the information might also be taking place.

彼はあなたに話していますよ、先生。He's talking to you, doctor.

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